Operative treatment of syndesmotic disruptions without use of a syndesmotic screw: a prospective clinical study.

Abstract:

:A new protocol for the selected omission of transsyndesmotic fixation in Weber class C ankle fractures was prospectively evaluated in 21 consecutive patients. As proposed in a previous cadaveric study (J. Bone Joint Surg., 71A:1548-1555, 1989), the protocol suggested that transsyndesmotic fixation was not required if (1) rigid bimalleolar fracture fixation was achieved or (2) lateral without medial fixation was obtained (i.e., with accompanying deltoid tears) if the fibular fracture was within 4.5 cm of the joint. According to this protocol, only 3 of 21 patients (14%) required transsyndesmotic fixation. Ten of the patients who did not receive transsyndesmotic fixation underwent pronation-external rotation stress radiographs in a fashion analogous to the previous cadaveric study. At 1- to 3-year follow-up, no stress (N = 10) or static view (N = 18) widening of the mortise or syndesmosis was seen in any patient, which supports (with the above guidelines) a limited, rather than routine, use of supplemental transsyndesmotic fixation. Clinical results from this prospective study seem to substantiate previously proposed biomechanical guidelines for the selected omission of transsyndesmotic fixation. Given these guidelines, transsyndesmotic fixation was unnecessary in many cases and the need can be determined before surgery by assessing the integrity of the deltoid ligament and level of the fibular fracture.

journal_name

Foot Ankle Int

authors

Yamaguchi K,Martin CH,Boden SD,Labropoulos PA

doi

10.1177/107110079401500801

subject

Has Abstract

pub_date

1994-08-01 00:00:00

pages

407-14

issue

8

eissn

1071-1007

issn

1944-7876

journal_volume

15

pub_type

临床试验,杂志文章
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    更新日期:2002-04-01 00:00:00

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    更新日期:2011-02-01 00:00:00

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    更新日期:2008-02-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1177/107110070102201004

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  • Plantar fibromatosis--topical review.

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    pub_type: 杂志文章,评审

    doi:10.1177/1071100713505535

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    更新日期:2013-12-01 00:00:00

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    doi:10.1177/107110079801901207

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    doi:10.1177/107110070202301002

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    pub_type: 临床试验,杂志文章,随机对照试验

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    更新日期:1999-04-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1177/1071100719901119

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    更新日期:2020-04-01 00:00:00

  • Clinical tips: retrograde drilling of talar osteochondral defects.

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    doi:10.3113/FAI.2008.0616

    authors: Kennedy JG,Suero EM,O'Loughlin PF,Brief A,Bohne WH

    更新日期:2008-06-01 00:00:00

  • Angioleiomyoma: clinical presentation and surgical management.

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:10.1177/107110070102200403

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    pub_type: 杂志文章

    doi:10.1177/1071100719861099

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    更新日期:2019-07-01 00:00:00

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    pub_type: 杂志文章,评审

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:10.3113/FAI.2007.0001

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    更新日期:2007-01-01 00:00:00

  • Radiographic changes and clinical results of osteochondral defects of the talus with and without subchondral cysts.

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